Overall Fertility Impact of New Contraceptive Methods May Be Limited

Abstract

Increasing overall contraceptive prevalence to reduce unwanted births in developing countries was the hypothesis of a project under the Demographic and Health Surveys carried out in 8 developing countries. Peru had the highest rate of unwanted births (36%) and served as the primary target of the analysis. Unwanted fertility comprised 30% of urban 41% of rural 43% of uneducated mothers and 23% of educated mothers births. Five years prior to the survey there were 12.4% unwanted births per 100 woman-years: 0.1 births for sterilized women 0.9 for IUD users 2.0 for pill users 12.4 for rhythm users and 18.5 for nonusers of contraceptives. If half of the 43% of women not using contraceptives started using one a 32% reduction of unwanted births would occur and total fertility rate TFR would be 3.6 lifetime births per woman. If use became total however the unwanted fertility rate would fall by 54% and TFR would stand at 3.4 births. A new contraceptive attracting 25% of nonusers would result in a 41% reduction of unwanted births and a TFR of 3.5 births. Although contraceptive use has been increasing in Peru since 1976 a 39% level of nonuse would only result in a 15% decrease of unwanted fertility rate in 1991 and a TFR of 3.8 births. Therefore the potential of total fertility rate reduction by increased contraceptive use is limited and the involvement of nonusers seems to be the most effective approach.